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Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Background and Objective: Type 2 diabetes is known to increase the risk and progression of certain types of cancer. Metformin treatment of diabetic patients is reported to have beneficial effects on some cancers. We evaluated the clinical outcome of diabetic patients with differentiated thyroid cancer (DTC) according to metformin treatment. Methods: We reviewed 943 patients diagnosed with DTC after total thyroidectomy between 1995 and 2005 in a tertiary hospital. The study involved 60 diabetic patients and 210 control patients matched for age, sex, body mass index (BMI), and tumor size. Results: There were no differences in the clinicopathological features and disease-free survival (DFS) between diabetic patients and the control group over 8.9 years of follow-up. Of the diabetic patients with DTC, 35 patients (58%) were treated with metformin. There were no differences in age, sex, BMI, tumor size, antidiabetic medication, glycated hemoglobin, or C-peptide levels in metformin and nonmetformin groups. However, cervical lymph node (LN) metastasis was more prevalent in the metformin group than in the nonmetformin group (OR 3.52, p = 0.035). Among diabetic patients with cervical LN metastasis of DTC, the metformin subgroup (17.1 years) was associated with longer DFS than the nonmetformin subgroup (8.6 years) (HR 0.16, p = 0.021); metformin treatment was also associated with longer DFS in this subgroup in multivariate analysis after adjusting age, BMI, duration of diabetes, presence of tumor at resection margin, and serum thyroglobulin level at ablation (HR 0.03, p = 0.035). Conclusions: Metformin treatment is associated with low recurrence in diabetic patients with cervical LN metastasis of DTC.
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Background: The BRAF<sup>V600E</sup> mutation is common in papillary thyroid cancer (PTC). Lymph node metastasis (LNM) may be associated with poor prognosis. However, the LNM mechanism remains unclear. Objectives: Our aim was to evaluate the prevalence of the BRAF<sup>V600E</sup> mutation in primary tumors and accompanying LNM at the time of diagnosis. Methods: This retrospective study included 51 PTC patients (40 women, 11 men; mean age 40.0 ± 16.5 years; range 6-81) who underwent total thyroidectomy accompanied by a lateral neck dissection due to preoperatively detected LNM. Real-time PCR was used for the detection of the BRAF<sup>V600E</sup> mutation in specimens from primary thyroid tumors and metastatic lymph node tumors. Results: The prevalence of the BRAF<sup>V600E</sup> mutation was 64.7% (n = 33) in primary tumors and 47.1% (n = 24) in metastatic lymph nodes. Of 33 patients with BRAF<sup>V600E</sup>-positive primary tumors, 18 (54.5%) had BRAF<sup>V600E</sup>-positive metastatic lymph nodes. Of 18 patients with BRAF<sup>V600E</sup>-negative primary tumors, 6 (33.3%) had BRAF<sup>V600E</sup>-positive metastatic lymph nodes. The presence of the BRAF<sup>V600E</sup> mutation in the primary tumor did not affect the tumor size, but the diameter of metastatic lymph nodes significantly increased (by nearly 3 mm) with the presence of BRAF<sup>V600E</sup> in LNM (p = 0.01). Conclusions: In our study, the BRAF<sup>V600E</sup> mutation did not show a one-to-one correspondence. This indicates that the presence of BRAF<sup>V600E</sup> in the primary tumor is not clonal and addresses the role of intratumor heterogeneity in PTC tumorigenesis. This supports the theses that mutations occur in the later stages of tumorigenesis, might be subclonal, and develop de novo, or that some other factors may be involved in the development of metastasis.
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Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, China
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manifested in 19 children (54.3%) and in 21 adolescents (60.0%; p = 0.629). The proportions of T1–T2 stage in CG and AG were 17.1% and 37.1% (χ 2 = 3.540, p = 0.060), respectively. Cervical lymph node metastasis was more prevalent in CG (94.3% vs. 74
Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
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Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
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biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer . World Journal of Surgery 2005 29 483 – 485 . ( https://doi.org/10.1007/s00268-004-7701-0 ) 11 Moon JH Kim YI Lim JA Choi HS Cho SW Kim
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Department of Otorhinolaryngology–Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Department of Otorhinolaryngology–Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
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Department of Otorhinolaryngology–Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Objective
Active surveillance (AS) is generally accepted as an alternative to immediate surgery for papillary thyroid carcinoma (PTC) measuring ≤1.0 cm (cT1a) without risk factors. This study investigated the clinicopathologic characteristics of PTCs measuring ≤2.0 cm without cervical lymph node metastasis (cT1N0) by tumor size group to assess the feasibility of AS for PTCs between 1.0 cm and 1.5 cm (cT1b≤1.5).
Design
This study enrolled clinically T1N0 patients with preoperative ultrasonography information (n= 935) from a cohort of 1259 patients who underwent lobectomy and were finally diagnosed with PTC from June 2020 to March 2022.
Results
The cT1b≤1.5 group (n = 171; 18.3 %) exhibited more lymphatic invasion and occult central lymph node (LN) metastasis with a higher metastatic LN ratio than the cT1a group (n = 719; 76.9 %). However, among patients aged 55 years or older, there were no significant differences in occult central LN metastasis and metastatic LN ratio between the cT1a, cT1b≤1.5, and cT1b>1.5 groups. Multivariate regression analyses revealed that occult central LN metastasis was associated with age, sex, tumor size, extrathyroidal extension, and lymphatic invasion in patients under 55, while in those aged 55 or older, it was associated only with age and lymphatic invasion.
Conclusion
For PTC patients aged 55 years or older with cT1b≤1.5, AS could be a viable option due to the absence of a significant relationship between tumor size and occult central LN.
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Aspiration biopsy of the cervical lymph node metastasis and measurement of Tg in the washout fluid of the needle with saline (0.5 mL) was performed. Tg immunohistochemistry After surgery, the thyroid and cervical lymph nodes were fixed in 10% neutral
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cervical lymph node metastasis . Horumon To Rinsho . 2017 Jun ; 86 ( 6 ): 845 – 51 . 10.1111/cen.13322 0045-7167 20 Sugitani I , Toda K , Yamada K , Yamamoto N , Ikenaga M , Fujimoto Y . Three distinctly different kinds of
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.10.2015-26/30). Patients with a history of previous thyroidectomy and with clinical findings suggestive of either central or lateral cervical lymph node metastasis were excluded. The data retrieved from an existing database included patient demographics, family history of
Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
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Otolaryngology, Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
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age-groups [ 11 ]. These synchronous carcinomas can present as a single tumor with mixed features, a single tumor with 2 distinct components, or as 2 tumors separated by normal thyroid tissue [ 12 - 15 ]. In some of these patients, cervical lymph
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.0244 24044517 16 Jeon MJ, Kim WG, Jang EK, Choi YM, Lee Y-M, Sung T-Y, Yoon JH, Chung K-W, Hong SJ, Baek JH, Lee JH, Kim TY, Shong YK, Kim WB: Thyroglobulin level in fine-needle aspirates for preoperative diagnosis of cervical lymph node metastasis in
